The short answer.
Both are prescription opioids used for pain. Both work by acting on the same parts of the body. Both carry significant risk of dependence with regular use.
The main differences are relative strength, which products contain each one, and how each shows up on drug testing.
What each one is
Two different opioids, used similarly.
Oxycodone is the opioid in Percocet (combined with acetaminophen), Roxicodone (oxycodone alone), and OxyContin (oxycodone in an extended-release form).
Hydrocodone is the opioid in Vicodin (combined with acetaminophen) and Norco (also combined with acetaminophen, at a different ratio).
Generic versions of all are available. Both are semi-synthetic opioids — meaning they are made by chemically modifying substances found naturally in the opium poppy.
Strength
Oxycodone is somewhat stronger.
On a dose-for-dose basis, oxycodone is roughly one and a half times stronger than hydrocodone. 10mg oxycodone is approximately equivalent to 15mg hydrocodone.
The difference is moderate. But it matters for understanding dependence: oxycodone can produce comparable effects at lower milligram doses.
How they are prescribed
Different formulations, similar uses.
Hydrocodone is almost always prescribed with acetaminophen (Vicodin, Norco).
Oxycodone is available in more forms — with acetaminophen (Percocet), alone (Roxicodone), and in an extended-release formulation (OxyContin).
Drug testing
They show up differently on drug tests.
Neither is guaranteed to be found on a basic urine drug screen, which is designed primarily to detect morphine and codeine.
Hydrocodone is more likely to be caught on basic screens than oxycodone. In treatment settings, more specific tests are used to identify each one reliably.
See more on oxycodone detection and hydrocodone detection.
Dependence
Both carry risk of physical dependence.
With regular use, the body adapts to either medication. Stopping either one causes withdrawal. This can happen even when taken as prescribed.
Physical dependence reflects how the drug interacts with the body, not how the person behaves.
Treatment
Both are treatable with Suboxone.
At MyStreetHealth, Suboxone (buprenorphine) treatment is available for dependence on either oxycodone or hydrocodone. The evaluation, approach, and ongoing care are the same.
Timing of the first dose depends on what you were taking. Your physician walks you through this at your first visit.
Common questions
Questions people usually have.
Is oxycodone stronger than hydrocodone?
Yes. Oxycodone is roughly 1.5 times stronger than hydrocodone on a milligram-for-milligram basis.
Which is more addictive?
Both carry comparable risk of dependence. The risk with either increases with regular use, higher doses, and longer duration.
What is the difference between Percocet and Vicodin?
Both combine an opioid with acetaminophen. The difference is the opioid: Percocet contains oxycodone, and Vicodin contains hydrocodone.